US20150127027A1 - Tissue Contacting Member - Google Patents
Tissue Contacting Member Download PDFInfo
- Publication number
- US20150127027A1 US20150127027A1 US14/071,331 US201314071331A US2015127027A1 US 20150127027 A1 US20150127027 A1 US 20150127027A1 US 201314071331 A US201314071331 A US 201314071331A US 2015127027 A1 US2015127027 A1 US 2015127027A1
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- United States
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- soft tissue
- fixation
- bone
- friction
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- Granted
Links
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- 210000000988 bone and bone Anatomy 0.000 claims abstract description 59
- 238000000034 method Methods 0.000 claims description 25
- 239000007769 metal material Substances 0.000 claims description 5
- 238000005096 rolling process Methods 0.000 claims description 3
- 239000002861 polymer material Substances 0.000 claims description 2
- 210000003041 ligament Anatomy 0.000 description 14
- 210000001519 tissue Anatomy 0.000 description 7
- 210000001264 anterior cruciate ligament Anatomy 0.000 description 6
- 210000002303 tibia Anatomy 0.000 description 6
- 210000003484 anatomy Anatomy 0.000 description 5
- 239000000463 material Substances 0.000 description 5
- 230000007613 environmental effect Effects 0.000 description 3
- 210000002758 humerus Anatomy 0.000 description 3
- 238000003780 insertion Methods 0.000 description 3
- 230000037431 insertion Effects 0.000 description 3
- RTAQQCXQSZGOHL-UHFFFAOYSA-N Titanium Chemical compound [Ti] RTAQQCXQSZGOHL-UHFFFAOYSA-N 0.000 description 2
- 239000000853 adhesive Substances 0.000 description 2
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- 230000002708 enhancing effect Effects 0.000 description 2
- 238000005530 etching Methods 0.000 description 2
- 238000002513 implantation Methods 0.000 description 2
- 238000004080 punching Methods 0.000 description 2
- 210000000513 rotator cuff Anatomy 0.000 description 2
- 238000001356 surgical procedure Methods 0.000 description 2
- 229910052719 titanium Inorganic materials 0.000 description 2
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- 210000000689 upper leg Anatomy 0.000 description 2
- 241000587161 Gomphocarpus Species 0.000 description 1
- 208000024288 Rotator Cuff injury Diseases 0.000 description 1
- 208000027418 Wounds and injury Diseases 0.000 description 1
- 238000004873 anchoring Methods 0.000 description 1
- 239000000560 biocompatible material Substances 0.000 description 1
- 230000015572 biosynthetic process Effects 0.000 description 1
- 210000004190 broad ligament Anatomy 0.000 description 1
- 239000000788 chromium alloy Substances 0.000 description 1
- 210000003109 clavicle Anatomy 0.000 description 1
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Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/08—Muscles; Tendons; Ligaments
- A61F2/0811—Fixation devices for tendons or ligaments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/08—Muscles; Tendons; Ligaments
- A61F2/0811—Fixation devices for tendons or ligaments
- A61F2002/0817—Structure of the anchor
- A61F2002/0823—Modular anchors comprising a plurality of separate parts
- A61F2002/0829—Modular anchors comprising a plurality of separate parts without deformation of anchor parts, e.g. fixation screws on bone surface, extending barbs, cams, butterflies, spring-loaded pins
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/08—Muscles; Tendons; Ligaments
- A61F2/0811—Fixation devices for tendons or ligaments
- A61F2002/0847—Mode of fixation of anchor to tendon or ligament
- A61F2002/0858—Fixation of tendon or ligament between anchor and bone, e.g. interference screws, wedges
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/08—Muscles; Tendons; Ligaments
- A61F2/0811—Fixation devices for tendons or ligaments
- A61F2002/0876—Position of anchor in respect to the bone
- A61F2002/0882—Anchor in or on top of a bone tunnel, i.e. a hole running through the entire bone
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/08—Muscles; Tendons; Ligaments
- A61F2/0811—Fixation devices for tendons or ligaments
- A61F2002/0876—Position of anchor in respect to the bone
- A61F2002/0888—Anchor in or on a blind hole or on the bone surface without formation of a tunnel
Abstract
Description
- The subject disclosure relates to a contacting system and/or member, and particularly to a friction, contacting, and/or fixation member able to be positioned relative to a soft tissue portion for reinforcement and/or fixation to a bone member.
- This section provides background information related to the present disclosure which is not necessarily prior art.
- Generally, in a surgical procedure soft tissue can be positioned or fixed relative to a portion of the anatomy, such as a bone portion. This soft tissue can be fixed with various techniques, including an anchor system, screw fixation system, and other appropriate fixation or anchoring mechanisms. The soft tissue, however, is generally fixed to a single member that is anchored to a boney portion for fixation of a soft tissue during and after the surgical procedure. The soft tissue, however, is generally fixed at a single fixation point. For example, a single pin or nail can pierce or contact the soft tissue for the single point of fixation with a fixation member at an end of a soft tissue portion.
- This section provides a general summary of the disclosure, and is not a comprehensive disclosure of its full scope or all of its features.
- A soft tissue portion can be fixed to a bone using a contacting member that can include a relatively large surface area. The contacting member can also be referred to as a friction pad or member. The contacting member can include a surface that is much larger than its thickness and/or a thickness of the soft tissue being fixed. The pad or the soft tissue contacting member can provide a large surface area that can be greater than a shaft of a fixation nail or screw to fix soft tissue relative to a second portion, such as a boney portion.
- The soft tissue contacting pad can be positioned between two or more layers of soft tissue. The layers of soft tissue can be layered as part of a continuous portion of soft tissue. The soft tissue portion can be folded upon itself, as discussed further herein. The soft tissue can also be naturally connected at a proximal or distal location. Thus, the soft tissue can be reconnected to a proximal humerus for repairing a rotator cuff tear. Additionally, the soft tissue contacting pad can be positioned between various layers of other selected soft tissue portions, such as an anterior cruciate ligament graft.
- The soft tissue fixation pad can include a surface area that is generally equivalent to a portion contacting soft tissue at an end or other appropriate portion of the soft tissue. The soft tissue fixation pad can further include a surface that is roughened and/or not smooth relative to the soft tissue position. Further, a fixation member can pass through the soft tissue and/or the soft tissue contacting pad to assist in fixing the soft tissue fixation pad and/or the soft tissue relative to a second structure, such as a bone portion. Further areas of applicability will become apparent from the description provided herein. The description and specific examples in this summary are intended for purposes of illustration only and are not intended to limit the scope of the present disclosure.
- The drawings described herein are for illustrative purposes only of selected embodiments and not all possible implementations, and are not intended to limit the scope of the present disclosure.
-
FIG. 1A is a view of a first side of a contacting or friction pad, according to various embodiments; -
FIG. 1B is a view of a second side of the contacting or friction pad, according to various embodiments; -
FIG. 2 is a view of a first side of a contacting or friction pad, according to various embodiments -
FIG. 3A is a detail environmental view of a first application of the friction pad, according to various embodiments; -
FIG. 3B is a greater environmental view of the first application of the friction pad, according to various embodiments; and -
FIG. 4 is an environmental view of a second application of the friction pad, according to various embodiments; -
FIG. 5A is a detail view of a soft tissue portion and one friction pad; -
FIG. 5B is a detail view of a portion of a fixation region of a soft tissue with friction pads, according to various embodiments; -
FIG. 6A is a detail view of a soft tissue portion and three friction pads; and -
FIG. 6B is a detail view of a portion of a fixation region of a soft tissue with friction pads, according to various embodiments. - Corresponding reference numerals indicate corresponding parts throughout the several views of the drawings.
- Example embodiments will now be described more fully with reference to the accompanying drawings.
- With reference to
FIG. 1A , a softtissue fixation pad 20 is illustrated. The softtissue fixation pad 20 can also be referred to as a soft tissue contacting member or pad. The softtissue fixation pad 20 can include a selectedthickness 22 which may vary depending upon an application and/or the position offixation pad 20 relative to an anatomy of a subject, such as a human patient. For example, fixation of a ligament, tendon, and/or muscle portion relative to a proximal humerus may allow for a section of the softtissue fixation pad 20 to have athickness 22 of any appropriate thickness. - The
thickness 22 of the softtissue fixation pad 20 may be selected, according to various embodiments, to be between about 0.1 millimeter and about 1 centimeter, including about 0.2 millimeter to about 10 millimeters, and further including about 0.2 mm to about 0.3 mm. As discussed herein, the surface area of at least one surface of thefixation pad 20 can be greater than the thickness or edge area. - The
fixation pad 20 may be provided to reinforce or strengthen a fixation region or zone, as discussed further herein. Various materials can be appropriately selected to provide stiffness and strength. For example, biocompatible materials including stainless steels, titanium, cobalt chromium alloys, etc. can be machined or worked into appropriate shapes and/or thicknesses. Further, selected polymer materials may also be formed in appropriate sizes for engaging the tissue. - The
friction pad 20 can include a surface area, such as any appropriate surface area that may be required or selected for a selected area or selected procedure. The surface area can be defined by afirst surface 24 and/or asecond surface 26. For example, both of thesurfaces friction pad 20 can be selected for procedure or location, such as selected by a user. Thefriction pad 20 may also be provided in various sizes, such as in a kit for selection by a user. - In various procedures, a ligament, such as the ACL may be selected to be fixed to a bone, such as a tibia (
FIG. 4 ). The ACL, and other ligaments of a human anatomy, may have an end near a natural insertion that is generally thick, tough, and appropriate for fixation to bone. After an injury and/or disease the natural fixation portion may be removed and/or damaged. Thus, the more distal portion of the ligament may be selected to be fixed to bone. The more distal portion is generally thinner and wider than the natural fixation end. - In various embodiments, the
friction pad 20 may be provided as a large member, as illustrated inFIG. 1 B, which may have lines ofperforation 28 that allow for user selection of a size by breaking, tearing, etc. along the lines of perforation. Moreover, thefriction pad 20 may be formed of a material that is able to be cut by a cutting instrument such as scissors, scalpel, or other sharp instruments. This may allow thefriction pad 20 to have a size selected while thepad 20 is manufactured in a single size, such as in a large sheet or member, and the user can select a size during a procedure, such as after an incision is made into a patient. - The
friction pad 20 can include various friction enhancements portion that can be formed as protrusions from one or more of thesurfaces friction pad 20. It is understood that the protrusions can be formed as alternating depression and protrusion portions. The protrusions can protrude from a main surface, such as thesurfaces friction pad 20. The protrusions may also extend from the edge or edge surface of thepad 20. The protrusion can also be formed as a surface or edge adjacent a depression formed into the surface of thepad 20. Nevertheless thepad 20 can include protrusions or friction enhancement portions that can assist in engaging and/or increasing friction relative to a soft tissue portion. - Various protrusions can include
pyramidal spikes 30, as exemplary illustrated in a selected portion of thefriction pad 20. Other friction enhancement portions can include thin orright angle pyramids 32. Other friction enhancement portions can include ridged flat topped orprotrusion members 34 that have a surface area that extends from the main surface of thefriction pad 20. The flattop protrusion members 34 can further include a friction enhancement portion formed thereon, such as ridges or fingers. Other friction enhancement portions can include single orthin fingers 36 that extend from the main surface of thefriction pad 20. - Other selected shapes of protrusions can be included such as barbs, hooks, etc. As a further example, illustrated in
FIG. 2 , afixation pad 20′ is illustrated that can have opposedsides 24′ and 26′. Thefixation pad 20′ may be formed of a metal material, including stainless steel alloys, titanium, etc. The metal material is generally selected to be biocompatible and appropriate for implantation in a subject, such as a human patient. The metal material can be worked or formed to have a thickness of about 0.1 mm to about 0.5 mm between thesides 24′, 26′. The thickness may be selected or formed such that during and after implantation thepad 20′ may flex to engage a bone surface thereby minimizing how far thefriction pad 20′ extends above the bone. - A
protrusion 38 can include a pointed triangle shape that can be formed by a die that is pushed or punched through thepad 20′. Theprotrusion 38 can be maintained in place by the properties of the metal material of thepad 20′. The tip of the protrusion can extend about 0.1 mm to about 1 mm from thesurface 24′. Theprotrusions 38 may also be formed by punching, machining, etching, or formed in other appropriate manners on at least one of thesurfaces 24′, 26′ of thepad 20′. In an embodiment theprotrusions 38 can be formed by chemically (e.g. photochemically) etching an area around the selected protrusion shape to form a recess into thesurface 24′, 26′. - The protrusions, including the
fingers 36, may assist in enhancing friction or engagement relative to the soft tissue. Moreover, it is understood that the exemplarily protrusions 30-36 discussed above, can be provided over an entire area of thefriction member 20 or over a small portion of thefriction pad 20. Additionally, the protrusions provided in a single friction pad can all be the same type of protrusion and/or it can be selected to be of a plurality of different shapes and sizes according to a selected design or purpose. - As discussed above the
friction pad 20 can include thesurfaces thickness 22 is generally the distance between thesurfaces surfaces surfaces surfaces surface - With reference to
FIGS. 3A and 3B , one or more of the friction pads, such as afirst friction pad 20 a, asecond friction pad 20 b, and athird friction pad 20 c can be fixed with a fixation member, including anail 40. It is understood that the threepads 20 a-20 c are not required. The number of pads used in a fixation area orregion 41 can be selected based on the type of tissue, selected area of contact, etc. For example, thefirst pad 20 a and thesecond pad 20 b can be used alone and a tissue portion can be folded in a “Z”-shape as discussed further herein. - The
nail 40 can includebarbed portions 42 that resist movement or removal from abone portion 44. Thefriction pad 20 can be used to assist in engaging or providing a surface area for contacting asoft tissue portion 50 for fixation relative to thebone portion 44. As illustrated inFIGS. 3A and 3B the soft tissue can be connected adjacent to or near a proximal end of humerus, which can be the bone portion of 44. The fixation can assist in repairing a tear of a rotator cuff to provide a fixation of soft tissue relative to thebone portion 44 to recover the natural anatomy. Thesoft tissue portion 40 can be naturally attached at a proximal portion of the soft tissue such as to a clavicle and or near a rib. - According to various embodiments, the
friction pads 20 a-20 c can be positioned to be wrapped or at least partially covered by thesoft tissue 50. The covering formation can include folding, such as in a “Z”-shape or overlapping configuration, as specifically illustrated inFIG. 3A . Thesoft tissue 50 can have a proximal connection near a center line of a patient and extend over theboney portion 44 to a fixation region where the soft tissue will be reattached. The fixation region can be selected by a user and/or selected based on the anatomy of the patient and the soft tissue. - A
first portion 50 a of thesoft tissue 50 can be positioned adjacent to thebone portion 44. Thefirst portion 50 a can provide a first region of soft tissue. Thefirst portion 50 a can have a first side orregion 50 a′ that contacts thebone 44 and asecond side 50 a″. A friction pad, such as thefirst friction pad 20 a, can have a first side, such as theside 24, positioned over the soft tissuefirst portion 50 a to contact thesecond side 50 a″ of thefirst portion 50 a. Thesoft tissue 50 can then be folded at a bend region over to be positioned on top thefriction pad 20 a, such as on thesecond side 26. The fold forms asecond portion 50 b of thesoft tissue 50. The second portion may have afirst side 50 b′ that contacts thesecond side 26 of thepad 20 a. Asecond side 50 b″of the second portion orregion 50 b opposed to thefirst side 50 b′ can contact a first side of thesecond friction pad 20 b that may be positioned over thesecond region 50 b. Thesoft tissue 50 can again be folded at a fold region over thefriction pad 20 b to form a third soft tissue portion orregion 50 c. Afirst side 50 c′ of thethird region 50 c may contact a second side of thesecond friction pad 20 b. Asecond side 50 c″ of thethird region 50 c, opposed to thefirst side 50 c′, may contact a first side of thethird pad 20 c. The soft tissue can be folded over thethird pad 20 c in a fold region to form afourth region 50 d. Afirst side 50 d′ of thefourth region 50 d may contact a second side of thepad 20 c. - It is understood that two or three of the
friction pads soft tissue portion 50 can be folded over the friction pads multiple times. Regardless of the number, thesoft tissue 50 is generally folded over each pad provided in a generally folded or “Z” shape. Generally, the “Z”-shape or zig-zag shape will have an “open” portion or region opposite the fold portion, as illustrated inFIGS. 3A-4 . Thus, thesoft tissue 50 may not need to roll around the pad in the folded configuration discussed above. Further, it is understood that the friction pad can be provided as the outer most portion. - After the
soft tissue 50 is folded over the friction pads, including any selected number of thefriction pads 20 a-20 c, thenail 40 can be driven through thesoft tissue regions 50 a-50 d and all of thefriction pads 20 a-20 c. Thenail 40 may have ahead 56 that engages asecond side 50 d″ opposed to thefirst side 50 d′ of thefourth region 50 d. As illustrated inFIG. 3A thenail 40 can be driven through thefriction pads 20 a-20 c and the regions of thesoft tissue 50 a-50 d into thebone portion 44 at thefixation region 41. The pads 20-20 c may also include a hole or bore that allows thenail 40 to pass through without piercing thepads 20 a-20 c while being driven therethrough. The head member orportion 56 can be driven, such as only axially, into thebone 44 with a hammer ordriver 58. As discussed above, thenail portion 40, however, can be provided to engage one of the friction pads that is placed on the exterior most portion of the fixation region. Thus, thenail head 56 need not contact an outer soft tissue layer or side. Thenail portion 40, may, however, be any appropriate fixation member including a screw, a barbed nail, or other member that provided to fix thesoft tissue portion 50 relative to thebone portion 44. - The
pads 20 a-20 c may include the protrusions to frictionally engage and bite into thetissue 50. It is understood, however, that thepad 20 may also be adhered to the soft tissue sides. Moreover, thefixation region 41 can be adhered to thebone 44 with appropriate adhesives. Thus, the protrusions need not be provided if thepads 20 are fixed to thetissue 50 in another manner, such as adhesive, and thenail 40 need not be used if thefixation region 41 is adhered or otherwise fixed to thebone 44. - According to various embodiments, the
friction pad 20 can be provided to contact other portions of soft tissue, such as an ACL graft or portion as illustrated inFIG. 4 . InFIG. 4 afemur 70 is illustrated relative to aproximal tibia 72. As is understood in the art, atunnel 74 can be formed through thetibia 72 and asoft tissue graph 76 can be passed through thetunnel 74. Thesoft tissue grapht 76 can be passed over two or more, or any selected number of thefriction pad 20, including only asingle friction pad 20, as discussed above, threefriction pads 20 a-20 c are illustrated inFIG. 4 . Accordingly, thesoft tissue 76 can include afirst region 76 a, asecond region 76 b, athird region 76 c, and afourth region 76 d, similar to theregions 50 a-50 d discussed above. The first pad member 20A can be positioned between the first andsecond regions second friction pad 20 b can be positioned between and contact the second andthird regions third friction pad 20 c can be positioned between the third andfourth regions pads 20 a-20 c can have sides that contact sides of thesoft tissue regions 76 a-76 d similar to thesoft tissue regions 50 a-50 d, as discussed above. - Again, the nail or
fixation member 40 can be driven through the various regions of thesoft tissue 76 a-76 d and thefriction pads 20 a-20 c into thetibia 72. Thefixation member 40 can include various features, such as barbed member portions, as discussed above, to assist in fixation of thenail member 40. Further, the fixation ofnail member 40 can include any appropriate fixation portion such as a nail, screw, barbed nail, or the like. - The method of fixing the soft tissue can be similar to that as described above. For example, the soft tissue can be a torn portion of a natural soft tissue portion. The soft tissue portion can be tensioned to an appropriate amount and affixed to a boney member, near or adjacent the first boney member, where a natural insertion of the soft tissue occurs. For example, a number of the pads can be selected to achieve a desired tension. The torn portion or region of the soft tissue can be folded to encapsulate and/or at least partially cover the friction pad, as discussed above. Moreover, a graft, for example is illustrated in
FIG. 4 , can be provided to connect to bone portions, including thefemur 70 and thetibia 72. As is understood in the art, thegraft 76 can be fixed to a second bone portion with the friction pad system as discussed above, or with other appropriate fixation members, such as the EZLoc® soft tissue fixation device sold by Biomet, Inc. Thefriction pad 20 can be used to fix a second end of the tissue portion, such as thegraft 76, at a second end, such as to thetibia 72 as discussed above. - The soft tissue graft or portion can be overlapped or folded over one or more of the
friction pads 20 to provide for a larger surface area for contacting soft tissue at thefixation region 41. The larger surface area can resist tearing, removal, or splitting of the soft tissue portion and/or graft when fixed with a fixation member, such as thenail 40. Accordingly, thefriction pad 20 can provide further or additional surface area for contacting the soft tissue portions when or while the fixation member, including thenail 40, is driven through the soft tissue and thefriction pad 20. Therefore thefriction pad 20 can resist pull-out or pull-away from thefixation member 40 after implementation and fixation to thebone portion 44. The friction pads can provide longevity and/or immediate fixation strength relative to the soft tissue. Thus, the friction pads can enhance fixation of the soft tissue relative to the bone portion. The friction pads, as discussed above, can be formed from materials that assist in providing longevity or enhanced fixation with thefixation member 44 that can enhance or augment fixation of the soft tissue with thefixation member 40 relative to the boney portions. - According to the various embodiments, the
pads pads pads nail 40 or other appropriate fixation member. Further, the folding and/ornumerous pads fixation region 41 can allow for selected tensions of thesoft tissue portion 50 without cutting or shortening thetissue 50. - With reference to
FIGS. 5A and 5B , asoft tissue portion 100 is illustrated. Thesoft tissue portion 100 includes at least two regions including a first narrow and/orthicker region 102 and a broad and/orthin region 104. Thethicker region 102 can be nearer an insertion region or point while the broad andthinner region 104 can be nearer a tear or position for fixation of theligament portion 100. Theligament 100 can be prepared for fixation to abone portion 110, as illustrated inFIG. 5B , with the use of one or more of a friction orfixation pad 120 including at least thefriction pad 120. More than one friction pad can be selected, including at least asecond friction pad 122 and athird friction pad 124. Each of the friction pads can include a structure on at least one surface. The structure can include the friction enhancement features, including at least one or more teeth or raisedregions 130 formed or extending from a surface to the friction pads 120-124. - The friction pads 120-124, or any appropriate number thereof, can be positioned on the thinner and
broader region 104 of theligament 100. As illustrated inFIGS. 5A and 5B , the respective friction pads can be positioned on a surface of theligament 100, such as in a region near a first side of the broad andthin region 104. Theligament portion 104 can then be rolled in a direction, such as in the direction ofarrow 140. After each turn of thebroad ligament region 104 that exposes a surface or portion that is not contacting a friction pad, a further friction pad can be positioned on the exposed surface, and the rolling can continue in the direction ofarrow 140. The broadenregion 104 of theligament 100 can continue to be rolled and turned until a bundle orfixation region 150 of the broadenregion 104 and the one or more friction pads 120-124 is formed. Thefixation region 150 including the friction pads 120-124 can be fixed to the bone portion and/orregion 110 with a fixation member, including thenail 40 illustrated and discussed above. Thenail 40 can include a taper orbarbed portion 42 and a contacting orfixation head 56. Thefixation head 56 can contact one or more of the friction pads, such as thefriction pad 124, or directly contact theligament 100 as illustrated inFIG. 5B . - Accordingly the
ligament 100, or any other appropriate soft tissue region, can be prepared with one or more of the friction pads 120-124 to be fixed to thebone portion 100. As illustrated and discussed above, the friction pads 120-124 can form or assist in enhancing a region to be fixed to thebone portion 110. The friction pads 120-124 can include features and/or can be formed of materials similar to those discussed above for the friction pads. The friction pads 120-124 can assist in resisting removal or tear through of the soft tissue from the fixation member including thenail 40. The friction pads 120-124 can include surfaces that contact the soft tissue surfaces to assistance in ensuring fixation of the friction pad relative to the soft tissue. Moreover, the friction pads 120-124 can include features, including the raisedregions 130, which may engage and contact the soft tissue to ensure fixation of the friction pads 120-124 relative to the soft tissue surfaces. - Turning references to
FIGS. 6A and 6B , asoft tissue portion 200 is illustrated, including a ligament or other soft tissue potion. Thesoft tissue portion 200 can include regions similar to thesoft tissue portion 100 illustrated inFIG. 5A including athick region 202 that is generally thicker and narrower than a flattenedthin region 204. The flattenedthin region 204 can have a width that is greater than the width of thethick region 202, but is generally a substantially thinner. Thethin region 204 can be made to engage or be positioned adjacent tofriction pads friction enhancement regions 220, such as those discussed above. Thefriction enhancement regions 220 can assist in engaging thesoft tissue 200 to resist movement to the friction pad 210-214 relative to the soft tissue. - The friction pads 210-212 can be positioned on or in the
thin region 204 such that thethin region 204 can be folded, including in a fan fold or creasing manner, relative to the friction pads 210-214. As illustrated inFIG. 6A , foldareas soft tissue 200 such that the soft tissue can be folded near or at the fold orcrease areas first edge 204 a of thethin region 204 can be folded generally in the direction ofarrow 240 over thefriction pad 210. The folded region, including theedge 204 a over thefriction pad 210 can then be folded back in the direction ofarrow 242 to cover or contact a surface of thefriction pad 212. - After fan folding the
thin region 204 back and forth in this manner, thethin region 204 can form afixation region 250, as illustrated inFIG. 6B . Thefixation region 250 can be fixed to abone portion 260 that can be any appropriate bone portion, including any of those discussed above. Thefixation region 250 can include the friction pads 210-214 that are completely or substantially surrounded by the soft tissuethin region 204. A fixation member, such as thenail 40, can be used to fix thefixation region 250 relative to the bone in 260. Again, thenail 40 can include ahead 56 that can contactsoft tissue portion 204 and various bone fixation enhancement regions, such as thebarb 42 to enhance fixation to thebone portion 260. - The
soft tissue portion 200 can then be fixed to thebone 260 at thefixation region 250. Thefixation region 250 can be enhanced with the friction pads 210-214 to assist in resisting pull through or tearing of the soft tissue after fixation with thefixation member 40. Again, it is understood, that the friction pads 210-214 can be formed to include features including those discussed above and illustrated and can also be formed of similar materials to the friction pads discussed above. For example, the friction pads 210-214 can be formed of a metal or metal alloy and thefriction enhancement portions 220 can be formed from the friction pads 210-214, such as by punching. Moreover, the friction pads 210-214 can be placed within folds of thesoft tissue region 204. Accordingly the soft tissue can be enhanced for fixation relative to a bone portion with a fixation member, including thenail 40, to assist in maintaining and/or securing fixation of soft tissue to a bone portion in a selective procedure. - It is understood that the various exemplary embodiments can include features in combination, though not exemplarily shown together. For example, the friction pads, according to various embodiments, may be formed and/or designed to bend and/or conform to a bone portion to minimize a thickness of a fixation region that includes the friction pads. Also, according to various embodiments, friction enhancement portions (e.g. 30, 32, 34, 36, 38, 130, 220) may be formed on two or more sides of each respective friction pad. For example, a die can be formed to punch alternating members or fingers on opposite sides of the friction pad.
- The foregoing description of the embodiments has been provided for purposes of illustration and description. It is not intended to be exhaustive or to limit the disclosure. For example, generally the soft tissue or portion thereof can be manipulated to contact a friction pad, according to various embodiments. The manipulation can include folding, rolling, creasing, etc. Individual elements or features of a particular embodiment are generally not limited to that particular embodiment, but, where applicable, are interchangeable and can be used in a selected embodiment, even if not specifically shown or described. The same may also be varied in many ways. Such variations are not to be regarded as a departure from the disclosure, and all such modifications are intended to be included within the scope of the disclosure.
- Example embodiments are provided so that this disclosure will be thorough, and will fully convey the scope to those who are skilled in the art. Numerous specific details are set forth such as examples of specific components, devices, and methods, to provide a thorough understanding of embodiments of the present disclosure. It will be apparent to those skilled in the art that specific details need not be employed, that example embodiments may be embodied in many different forms and that neither should be construed to limit the scope of the disclosure. In some example embodiments, well-known processes, well-known device structures, and well-known technologies are not described in detail.
Claims (23)
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US14/071,331 US9433493B2 (en) | 2013-11-04 | 2013-11-04 | Tissue contacting member |
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US14/071,331 US9433493B2 (en) | 2013-11-04 | 2013-11-04 | Tissue contacting member |
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US9433493B2 US9433493B2 (en) | 2016-09-06 |
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